Carol and Richard Yu Peritoneal Dialysis Research Centre, Departments of Medicine and Therapeutics, Prince of Wales Hospital, Hong Kong, China.
Li Ka Shing Institute of Health Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
Kidney Blood Press Res. 2019;44(5):1259-1270. doi: 10.1159/000502961. Epub 2019 Oct 4.
Endocan is associated with endothelial dysfunction. In peritoneal dialysis (PD) patients, cardiovascular disease is a common cause of mortality. We examined the relationship between serum endocan level and clinical outcome of PD patients.
We recruited 193 new PD patients (118 males, mean age 58.8 ± 11.6 years). Serum endocan levels were determined and stratified into tertile 1 (lowest) to 3 (highest). Nutritional status, arterial pulse wave velocity (PWV) and serum C-reactive protein (CRP) levels were measured. The patients were followed for at least 4 years for clinical outcomes.
For the whole cohort, patients with higher serum endocan levels had lower serum albumin and subjective global assessment score, higher carotid-femoral PWV, and higher serum CRP. For patients with suboptimal blood pressure (BP) control, cardiovascular event-free survival was 95.0, 95.5, and 78.5% for tertiles 1, 2, and 3 at 60 months respectively (p = 0.019). Multivariate Cox regression analysis showed that serum endocan level was an independent predictor of cardiovascular event-free survival. No association with cardiovascular event-free survival was found for patients with adequate BP control (95.0, 92.3, and 100% for tertile 1, 2, and 3 at 60 months, respectively, p = 0.6).
Higher serum endocan level is associated with unfavourable nutritional, arterial and inflammatory conditions in PD patients. In patients with suboptimal BP control, higher serum endocan is also associated with worse cardiovascular outcome.
Endocan 与血管内皮功能障碍有关。在腹膜透析（PD）患者中，心血管疾病是导致死亡的常见原因。我们研究了血清 Endocan 水平与 PD 患者临床结局的关系。
我们招募了 193 名新的 PD 患者（118 名男性，平均年龄 58.8 ± 11.6 岁）。测定血清 Endocan 水平，并分为三分位 1（最低）至 3（最高）。测量营养状况、动脉脉搏波速度（PWV）和血清 C 反应蛋白（CRP）水平。对患者进行至少 4 年的临床结局随访。
对于整个队列，血清 Endocan 水平较高的患者血清白蛋白和主观整体评估评分较低，颈动脉-股动脉 PWV 较高，血清 CRP 较高。对于血压（BP）控制不佳的患者，心血管事件无进展生存率分别为 60 个月时的三分位 1、2 和 3 组的 95.0%、95.5%和 78.5%（p = 0.019）。多变量 Cox 回归分析显示，血清 Endocan 水平是心血管事件无进展生存率的独立预测因子。对于血压控制良好的患者，与心血管事件无进展生存率无相关性（60 个月时三分位 1、2 和 3 组的 95.0%、92.3%和 100%，p = 0.6）。
较高的血清 Endocan 水平与 PD 患者不良的营养、动脉和炎症状况有关。在血压控制不佳的患者中，较高的血清 Endocan 也与心血管结局恶化有关。
